Individual
MS. ROXANNE MILES WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MN,FNP/GNP,DSD,PHN,C
Contact information
Practice address
5140 YOLANDA AVE, TARZANA, CA 91356-4027
(818) 344-8646
Mailing address
5140 YOLANDA AVE, TARZANA, CA 91356-4027
(818) 344-8646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN362861
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
6708
CA
363LG0600X
Gerontology Nurse Practitioner
RN362861
CA
Other
Enumeration date
08/07/2011
Last updated
04/23/2018
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